When am I eligible?

When am I eligible for Medicare Coverage?

There are a number of requirements to be eligible to receive Medicare coverage. This page will serve as a guide to understanding if you qualify to receive benefits through the Medicare program.

Most seniors over the age of 65 qualify for Medicare coverage. You should be eligible for Medicare at the age of 65 if the following requirements are met:

In order to receive Medicare benefits you must be a U.S. citizen or legal resident

You must have resided in the United States for a minimum of 5 years

You must have worked at least 10 years in Medicare-covered employment

If the information above applies to you and you have has Social Security deductions taken from your payroll, chances are that you will automatically receive a Medicare card in the mail prior to becoming eligible. The Medicare card will contain benefits on both Medicare Part A (hospital care) and Medicare Part B (medical care).

Medicare Part B is optional and can be declined. The Part B option of Medicare requires a monthly premium to be paid monthly to participate.

You will have to apply for Medicare Part B if:

You have not applied for Social Security or Railroad Retirement benefits

You were employed by the government

You have kidney disease

You can qualify for Medicare benefits if you are under the age of 65 in the following situations:

You have End State Renal Disease (ESRD), or

You have received Social Security Disability Income (SSDI) payments for 24 months, or

you have received Social Security Disability Income (SSDI) payments for 1 month and have ALS/Lou Gehrig's Disease

Not all medical expenses are covered by Medicare Part A and Medicare Part B. Items including:

Prescription Drugs

Premiums

Co-Pays

These are considered out-of-pocket expenses unless you have additional coverage under one of the many different plans available including: Medicare Supplemental Insurance (Medigap), Medicare Part D, and Medicare Advantage Plans.

A comprehensive list of services and expenses that are not covered under Medicare Part A or Medicare Part B can be found below.

Deductibles, coinsurance, or copayments for certain health services

Routine eye care and glasses

Eye refractions

Yearly physical exams (Medicare Part B will cover 1 physical within the first 6 months)

Some diabetic supplies

Chiropractic services

Hearing aids, exams, or tests

Acupuncture

Custodial care at home or in a nursing home including: assistance bathing, dressing, going to the bathroom and eating